What Is a Letter of Protection in a Florida Injury Case?

Hollywood Car Accident Lawyer | Daniel B Reinfeld, PA

Last updated: August 28, 2026

A letter of protection is one of the more important — and, since 2023, one of the more legally complicated — tools available to an injured person in Florida who needs medical treatment but can't pay for it out of pocket while a claim is still pending. Understanding both what it is and how the law around it has changed requires careful preparation, because getting it wrong can affect not just your treatment, but the value of your entire case.

What a Letter of Protection Actually Is

A letter of protection (LOP) is an agreement between an injured person (or their attorney) and a medical provider: the provider agrees to treat the patient now, without requiring payment upfront, in exchange for a promise to be paid directly out of the eventual settlement or judgment. It's not free care — it's deferred payment, secured by the value of the claim itself.

LOPs matter enormously in Florida given how many injured people fall into billing gaps: no health insurance, PIP benefits exhausted, or a provider unwilling to accept accident-related treatment through standard insurance. Without an LOP, some people would simply go without necessary treatment while their case is pending — which helps no one, least of all their recovery.

How Things Changed in 2023

Florida's sweeping tort reform law (HB 837) didn't ban letters of protection, but it fundamentally changed how they — and medical expenses generally — are handled in litigation, through a new statute: Fla. Stat. § 768.0427. If you were treated under an LOP before 2023, the rules your case is judged by may look meaningfully different than they do today.

Juries No Longer Simply Hear the Full Billed Amount

Before this reform, a common and often effective practice was presenting a jury with the full, undiscounted billed charges for medical treatment — numbers that routinely far exceeded what any insurer, Medicare, or Medicaid would ever actually pay for the same services. Under the new law, evidence of medical expenses is now generally limited to:

• The amount actually paid for treatment already rendered, "regardless of the source of payment," for bills that have been paid; and

• For unpaid bills — including many LOP balances — evidence tied to what health insurance would have paid under its contracted rates, or, for uninsured claimants, benchmarks referencing Medicare and Medicaid reimbursement rates, rather than the full sticker-price charge.

The practical effect is that the "special damages" number presented to a jury — and, by extension, the number insurance adjusters use as a reference point during settlement negotiations — is generally lower and more tightly tethered to real-world reimbursement rates than it often was before 2023.

Referral Relationships Must Now Be Disclosed

This is the change that's reshaped how attorneys handle LOP referrals specifically. Under the new statute, if a claimant was treated under a letter of protection, the claimant must disclose whether the referral came from their attorney — and if it did, that referral, along with the broader financial relationship between the law firm and the medical provider (including the volume, frequency, and financial benefit of past referrals), is now admissible evidence at trial, specifically as it relates to the credibility and potential bias of a testifying medical provider.

In plain terms: if a law firm repeatedly sends clients to the same provider under LOPs, the defense can now bring that pattern in front of the jury to argue the provider's testimony about your injury is influenced by an ongoing financial relationship with your attorney — not just neutral medical opinion.

Factored Medical Receivables Must Be Disclosed Too

Some medical providers sell their unpaid accounts to third-party "factoring" companies at a discount, in exchange for faster payment. If that happened with your bills, the discounted price the factoring company actually paid for the receivable — not just the original billed amount — must now be disclosed.

What This Means If You're Being Treated Under a Letter of Protection Today

None of this makes letters of protection a bad option — for many injured people, they're still the only realistic path to necessary treatment. But it does mean the choice of provider, and the transparency around that choice, matters more than it used to:

• Ask your attorney how the provider you're being referred to was selected, and understand that referral pattern may become relevant evidence later.

• Get a clear, itemized understanding of what you'll actually owe at settlement — not just the sticker-price bill, since that number may not be what ultimately gets presented or paid.

• Understand that your case's medical damages figure may look different — often lower in headline terms — than it might have before 2023, even though your actual medical needs and treatment are unchanged.

What Else Changed Alongside This

This reform didn't happen in isolation. It arrived alongside the same 2023 tort reform package that shortened Florida's negligence statute of limitations from four years to two (Fla. Stat. § 95.11(5)(a)) and moved Florida to a modified comparative negligence system with a 51% bar to recovery (Fla. Stat. § 768.81(6)). Taken together, these changes mean building a Florida injury case today — documenting damages correctly, choosing treatment providers thoughtfully, and moving quickly — matters more than it did just a few years ago.

Frequently Asked Questions

Does a letter of protection cost me more than paying out of pocket would? Not inherently — you're being billed for the treatment you received either way. What changed is how that bill gets evaluated and presented if your case goes to trial.

Can I choose my own doctor instead of one my attorney refers me to? Yes, absolutely. Many clients already have trusted providers, and using them avoids any referral-relationship question entirely.

Will this affect my settlement even if my case never goes to trial? Yes — insurance adjusters value claims with an eye toward what would happen at trial, so the same admissibility rules that would apply in front of a jury shape how adjusters evaluate a demand during negotiation, too.

Call Today. Discuss Directly With Dan.

Understanding how letters of protection and Florida's 2023 medical-expense reforms affect your specific case requires careful preparation — this is exactly the kind of detail that changes how a claim should be built and presented. When you call Reinfeld Law, you speak directly with Dan Reinfeld, an attorney with more than 25 years of experience who stays current on exactly these kinds of legal changes, not a call center reading from a script. Dan offers flexible consultation options, including phone, Zoom, hospital, and home visits. Consultations are free, and you pay nothing unless he recovers money for you. Evening and weekend appointments are available. Call (954) 923-6110 today to discuss your Florida car accident claim directly with Dan.